Reimbursement Roundup
August 1, 2001 3 minutes read
Reimbursement Roundup
Supervisory rule added to bad-rule hit list
The list of troublesome regulations physician leaders would like to scuttle has grown to include rules that physicians must follow in supervising medical residents. The Physicians’ Regulatory Issues Team at the Centers for Medicare and Medicaid Services (CMS) has added that requirement to its list of rules that cause doctors the greatest hassles.
"Physicians tell us these requirements are confusing and may lead to debatable errors," says Barbara Paul, MD, CMS medical advisor and director of the team of outside physicians appointed to work with agency staff on streamlining its regulatory methods.
This item is now added to the team’s list of top problems faced by doctors who participate in Medicare. The team plans to address the problems on its list. Already on the list: coverage of preoperative evaluations, advance beneficiary notices, coverage of follow-up visits, certificates of medical necessity, and laboratory services.
HHS task force will target patient safety
Department of Health and Human Services (HHS) Secretary Tommy Thompson has announced that a new Patient Safety Task Force has been established to coordinate a joint effort among several agencies to improve existing systems to collect data on patient safety.
These agencies include The Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Centers for Medicare and Medicaid Services. HHS’ fiscal 2002 budget proposal includes $72 million for efforts to improve patient safety and reduce the number of adverse events, an increase of $15 million over fiscal year 2001.
In addition, Thompson has charged the task force with studying how to implement a user-friendly Internet-based patient safety reporting format. The group will develop computer networks, user-friendly reporting systems, and standards for coding the content of the reports, reports AHA News. The system will feature a uniform data collection method. The Centers for Disease Control and Prevention and the Food and Drug Administration will provide data on medical errors, while the Agency for Healthcare Research and Quality will analyze the causes of medical errors.
Hospital profit margins show negligible increase
Operating profit margins at U.S. hospitals flattened at an annualized average of 3.69% in 2000, indicating only a slim degree of financial health, according to a report by Evanston, IL-based Solucient, a provider of benchmark information on health care.
Hospital operating margins increased 0.41% over 1999 and remained relatively low, a full 36.6% lower than in 1997. Solucient president Gregg Bennett says margins of 3%-4% are not sustainable in the long run, especially given the pressure from drug costs and labor shortages. He also says hospitals are still feeling the sting of the 1997 Balanced Budget Act and its clamp on Medicare payments.
According to the study, "The Health of Our Nation’s Hospitals," smaller hospitals finished the year at 4.84%, their highest operating margin since 1997. Larger hospitals produced the slimmest operating margins at 2.83%. Regionally, western hospitals posted the weakest operating margins at 3.9%, while northeastern hospitals fared the best, going from breaking even in 1999 to almost 5% in 2000. For more information, visit www.solucient.com.
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